Misdiagnosis of Multiple Sclerosis

A diagnosis of multiple sclerosis can be elusive because symptoms, such as fatigue, muscle weakness, and dizziness, can be vague. Symptoms can also vary greatly between individuals and mimic other diseases. Because of these factors, a diagnosis of the condition may be delayed or overlooked.

There is no single test that will specifically diagnose the multiple sclerosis. A definitive diagnosis of multiple sclerosis is made by a neurologist after performing a thorough neurological history and physical examination and multiple tests to rule out other conditions that can be confused with multiple sclerosis. These conditions include some viral infections, lupus, lime disease, and vitamin deficiencies. Tests may include blood tests, a lumbar puncture, and an MRI, which may show the brain and spinal cord damage and lesions characteristic of multiple sclerosis....more about Multiple Sclerosis »

Alternative diagnoses list for Multiple Sclerosis:

For a diagnosis of Multiple Sclerosis,
the following list of conditions
have been mentioned in sources
as possible alternative diagnoses
to consider during the diagnostic process for Multiple Sclerosis:

Undiagnosed stroke leads to misdiagnosed aphasia: BBC News UK reported on a man who
had been institutionalized and treated for mental illness
because he suffered from sudden inability to speak.
This was initially misdiagnosed as a "nervous breakdown" and other mental conditions.
He was later diagnosed as having had a stroke, and suffering from aphasia (inability to speak),
a well-known complication of stroke (or other brain conditions).

Dementia may be a drug interaction: A common scenario in aged care is for
a patient to show mental decline to dementia.
Whereas this can, of course, occur due to various medical conditions,
such as a stroke or Alzheimer's disease,
it can also occur from a side effect or interaction between multiple drugs
that the elderly patient may be taking.
There are also various other possible causes of dementia.

Mild traumatic brain injury often remains undiagnosed: Although the symptoms
of severe brain injury are hard to miss,
it is less clear for milder injuries, or even those causing a mild concussion diagnosis.
The condition goes by the name of "mild traumatic brain injury" (MTBI).
MTBI symptoms can be mild, and can continue for days or weeks after the injury.
See the symptoms of MTBI or misdiagnosis of MTBI.

MTBI misdiagnosed as balance problem: When a person has symptoms
such as vertigo or dizziness, a diagnosis of brain injury may go overlooked.
This is particularly true of mild traumatic brain injury (MTBI), for which the
symptoms are typically mild. The symptoms has also relate to a relatively
mild brain injury (e.g. fall), that could have occurred days or even weeks ago.
Vestibular dysfunction, causing vertigo-like symptoms, is a common complication
of mild brain injury.
See causes of dizziness, causes of vertigo, or misdiagnosis of MTBI.

Post-concussive brain injury often misdiagnosed: A study found that soldiers who had
suffered a concussive injury in battle often were misdiagnosed on their return.
A variety of symptoms can occur in post-concussion syndrome and these were not being correctly
attributed to their concussion injury.
See introduction to concussion.

Children with migraine often misdiagnosed: A migraine often fails to be
correctly diagnosed in pediatric patients.
These patients are not the typical migraine sufferers, but migraines can also occur in children.
See misdiagnosis of migraine or introduction to migraine.

Failure To Diagnose Multiple Sclerosis

Failure to diagnose Multiple Sclerosis may be associated with the following:

Multiple sclerosis can vary greatly in severity which can make diagnosis difficult. Some people actually have no obvious symptoms their whole life and multiple sclerosis lesions may only incidentally be discovered during an MRI

The range and rate of progression of presenting symptoms for multiple sclerosis is extensive and often mimics other conditions which means that is often misdiagnosed a number of times before the actual cause is determined

Diagnostic difficulty is increased by the fact that many of the conditions that can be caused by multiple sclerosis may also exist independently of the disease. Examples include optic neuritis, acute disseminated encephalitis and acute transverse myelitis. When these condition present, health professionals need to investigate further in order to exclude multiples sclerosis as a diagnosis

Early diagnosis of multiple sclerosis allows timely treatment which can impact greatly on the quality of life

Multiple sclerosis is often undiagnosed or misdiagnosed if it occurs before the age of 20 or after the age of 50 as it is rare in these age brackets. As children are less likely to bring attention to any symptoms, they are more likely to remain undiagnosed, especially in cases where the symptoms come and go. Even if the symptoms are brought to the attention of a parent, they may be dismissed as harmless. For example, if a child complains of a vision problem, the parent may just assume that a foreign body has irritated it and it will heal on its own. Some of the symptoms that can occur in children are vision problems, weakness on one side of the body, incoordination, sleepiness, confusion and poor academic performance due to cognitive problems

Delayed diagnosis of multiple sclerosis can result in permanent vision impairment

People with undiagnosed multiple sclerosis are unaware that they need to avoid factors that can exacerbate their condition e.g. infectious diseases

Cognitive impairment caused by multiple sclerosis is often overlooked as it tends to be mild and somewhat subjective. Cognitive symptoms include impaired concentration, memory, judgement and attention

Multiple sclerosis can take many years to diagnose in patients where the symptoms tend to appear for a period of time, spontaneously disappear and then reappear

Some doctors delay treatment in newly diagnosed MS patients in order to determine the type of MS by the progression of symptoms. However, the benefits of this needs to be weighed up against the fact that delaying treatment can lead to and increased progression of disability and increased damage. Some health professionals believe that patients are being treated unnecessarily or for an unnecessary length of time. It is difficult to assess what effect treatment has in the long term prognosis as the progression of the disease is so variable that relapses may be due to treatment or spontaneous remission. More research needs to be done to determine the impact of treatment on the final outcome for various types of MS

There is no definitive test for MS which makes diagnosis difficult. Further investigative testing is often avoided due to expense

Notes On Hidden Causes Of Multiple Sclerosis

The following may be hidden causes of Multiple Sclerosis:

The exact cause is unknown in most cases but there are many theories

Some cases of multiple sclerosis (10-20%) appear to be inherited in a familial pattern

Some researchers believe that some people are genetically predisposed to developing multiple sclerosis but it will only occur when certain triggers are present e.g. environmental factors. Certain viruses and bacteria have been implicated as possible triggers e.g. Epstein-Barr virus

Research suggests that there is a link between living in a temperate climate during childhood (up to 15 years of age) and an increased risk of developing multiple sclerosis. A temperate climate is a climate that is quite stable and generally doesn't involve the extremities of weather conditions. Thus people who grew up in tropical areas appear less prone to multiple sclerosis. Moving to a temperate climate during adulthood does not appear to increase the risk of MS. Some researchers believe that the specific factors involved may be the protective effect of sunlight exposure and resultant vitamin D levels

Other researchers believe that a faulty immune system is the cause of the condition

Some researchers believe that viral infections can trigger an episode as can immune system changes such as occurs in the period after a pregnancy

Recent studies indicate that there is no link between hepatitis B vaccination during childhood and an increased risk of developing MS

There is still disagreement over whether factors such as allergic responses, immunization, physical stress, emotional stress and trauma can exacerbate or trigger and attack of multiple sclerosis

Infections (e.g. common cold, gastroenteritis, influenza) can exacerbate or trigger and attack of MS

Notes On Wrong Diagnosis Of Multiple Sclerosis

Wrong diagnosis of Multiple Sclerosis may be associated with the following:

Often conditions similar to multiple sclerosis are wrongly diagnosed as multiple sclerosis. Examples include lupus, Lyme disease, Devic disease and neuromyelitis optica

MS patients may be misdiagnosed as suffering from psychiatric disorders such as anxiety, somatization or conversion

Sometimes patients with B12 deficiency may be misdiagnosed as having MS which has serious repercussions as they won't receive treatment which can lead to recovery

British researchers are discovering a significant number of people who have been diagnosed with MS actually have Hughes syndrome (antiphospholipid syndrome) which can mimic the symptoms of MS. This misdiagnosis is serious as Hughes syndrome is easily treated but if untreated can have serious consequences such as wheelchair dependence or stroke

MS can be difficult to diagnose and it is sometimes diagnosed in cases where other possible causes have been eliminated. Diagnosis by using the process of elimination is a common cause of wrong diagnosis. In fact, people are often diagnosed as definitely having MS, definitely having MS and possibly having MS

Sometimes a condition called myalgic encephalitis (ME or ICD-DFS) is misdiagnosed as multiple sclerosis (especially the primary progressive form) as they may have similar symptoms

Complications Of Misdiagnosis Of Multiple Sclerosis

The following may be complications of misdiagnosis of Multiple Sclerosis:

Early vision problems caused by multiple sclerosis may be diagnosed simply as a vision problem due to old age or some other condition rather than multiple sclerosis

Some MS patients have an initial presentation of neuropsychological complaints (mood disturbance, history of depression, memory impairment, dysphasia and dysgraphia) which may be misdiagnosed as a psychological disorder

Other Notes On Misdiagnosis Of Multiple Sclerosis

Females are twice as likely to get multiple sclerosis as males

Medical news summaries about misdiagnosis of Multiple Sclerosis:

The following medical news items
are relevant to misdiagnosis of Multiple Sclerosis:

About misdiagnosis:

When checking for a misdiagnosis of Multiple Sclerosis
or confirming a diagnosis of Multiple Sclerosis,
it is useful to consider what other
medical conditions might be possible misdiagnoses or other alternative
conditions relevant to diagnosis.
These alternate diagnoses of Multiple Sclerosis may already have
been considered by your doctor or may need to be considered as possible
alternative diagnoses or candidates for misdiagnosis of Multiple Sclerosis.
For a general overview of misdiagnosis issues for all diseases,
see Overview of Misdiagnosis.

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